Early hyperbaric oxygen therapy improves survival in a model of severe sepsi

Reyes T, Okerblom J, Ramirez-Sanchez I, Villarreal F, Patel HH,Bickler SW, Perdrizet GA, De Maio A. Early hyperbaric oxygentherapy improves survival in a model of severe sepsis. Am J PhysiolRegul Integr Comp Physiol 317: R160 –R168, 2019. First publishedMay 15, 2019; doi:10.1152/ajpregu.00083.2019.—Sepsis is a majorclinical challenge, with therapy limited to supportive interventions. There fore, the search for novel remedial approaches is of great importance.We addressed whether hyperbaric oxygen therapy (HBOT) couldimprove the outcome of sepsis using an acute experimental mousemodel. Sepsis was induced in male CD-1 mice by cecal ligation and puncture (CLP) tailored to result in 80 –90% mortality within 72 h of the insult. After CLP, mice were randomized into two groups receiv ing HBOT or not at different times after the initial insult or subjected to multiple HBOT treatments. HBOT conditions were 98% oxygen pressurized to 2.4 atmospheres for 1 h. HBOT within 1 h after CLP resulted in 52% survival in comparison with mice that did not receive the treatment (13% survival). Multiple HBOT at 1 and 6 h or 1, 6, and 21 h displayed an increase in survival of 50%, but they were not significantly different from a single treatment after 1 h of CLP.Treatments at 6 or 21 h after CLP, excluding the 1 h of treatment, did not show any protective effect. Early HBO treatment did not modify bacterial counts after CLP, but it was associated with decreased expression of TNF- , IL-6, and IL-10 expression in the liver within 3 h after CLP. The decrease of cytokine expression was reproduced incultured macrophages after exposure to HBOT. Early HBOT could be of benefit in the treatment of sepsis, and the protective mechanism may be related to a reduction in the systemic inflammatory response. cytokines; hyperbaric oxygen therapy; sepsis; systemic inflammatory response